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Volume 78, Issue 5
Displaying 1-5 of 5 articles from this issue
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Yoshihiro KOBASHI, Naoyuki MIYASHITA, Yoshihito NIKI, Toshiharu MATSUS ...2003 Volume 78 Issue 5 Pages 383-387
Published: May 15, 2003
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSFive hundred twenty-one patients with pulmonary tuberculosis were diagnosed in our three affiliated hospitals during past 10 years. Among them, 43 cases (22 men and 21 women; mean age 54.8 years) who were detected by active case-finding were clinically evaluated. Most of them were detected in an annual mass screening examination, but seven cases were found by contacts examination which was performed on subjects who were contacted with newly diagnosed patients with pulmonary tuberculosis. Fifteen of them were socially jobless on admission. Eighteen cases (41.9%) had underlying diseases, and gastrointestinal diseases and diabetes mellitus were most frequently observed. The final diagnosis was confirmed through bronchoscopic specimens in 18 cases in which Mycobacterium tuberculosis could not be detected from the sputum. Regarding radiological findings according to the criteria of the Japanese Society of Tuberculosis, most cases had unilateral distribution, and were classified as type III (active, non-cavitary) for characteristics and 1 (minimal) for the extent of lesions. Treatment using combination therapy with four drugs including pyrazinamide was performed for over half of these cases and subsequently the clinicalefficacy was good except in one case who died due to worseningof the underlying disease.
Anti-tuberculous drugs were generally administered to cases suspected of having pulmonary tuberculosis on chest X-ray. However, early diagnosis using bronchoscopy and early treatment seems to be useful, when Mycobacterium tuberculosis is not detected in the sputum.View full abstractDownload PDF (746K) -
FROM CLINICAL SPECIMENSKazunari TSUYUGUCHI, Takeshi IKEDA, Koichi NAKATANI, Tomomasa TSUBOI, ...2003 Volume 78 Issue 5 Pages 389-393
Published: May 15, 2003
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSThe Mycobacteria Growth Indicator Tube (MGIT) system, a broth system for detection of mycobacterial growth, has been shown to be more sensitive and rapid compared with the egg-based Ogawa solid media, while the lack of ability to quantitate bacterial growth is the problem. We comparedmycobacterial growth in the MGIT and the Ogawa systems, and evaluated the relationship between detection time in the MGIT system and bacterial CFU on Ogawa egg medium. A total of 413 respiratory specimens from 245 patients were included in the study, of which Mycobacterium tuberculosis (MTB), M. avium complex (MAC) and M. kansasii were recovered from 127, 42 and 6 specimens, respectively. Recovery rates were significantly higher and detection time was significantly shorter in the MGIT than in the Ogawa for MTB and MAC. Detection time in the MGIT was significantly shorter in smear positive specimens than in smear negative ones for MTB and MAC. There was a significant negativecorrelation between CFUs on Ogawa egg medium and detection time in the MGIT system for the MTB, therefore, this system may have an ability to quantitate live mycobacteria according to the detection time.View full abstractDownload PDF (763K) -
Naomi SEKI2003 Volume 78 Issue 5 Pages 395-399
Published: May 15, 2003
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSThe number of tuberculosis outbreak among adult groups has increased. In some of them, it is difficult to identify the route of infection and sometimes many people are involved in the outbreak. We experienced a suspected case of mass outbreak in a small company separated into 2 floors.
The first patient, wholived in anothercity, was diagnosed as pulmonary tuberculosis in April with bilateral extensive cavitary lesions complicated with pleurisy on chest X-ray, and his sputum smear was Gaffky No.8 and culture (+) (resistant to isoniazid).
We conducted tuberculin skin test (TST) for those under-30 year-old. In TST, 4 persons showed strong positive reaction. After consulting with tuberculosis specialists, three were diagnosed as newly infected with tuberculosis and one as hilar lymph node tuberculosis. So we added 25 staffs under 60s for TST and found that another 13 people were suspected to be infected with tuberculosis.
From the initial information, the index cast was said to work only in the 2nd floor, so the staffs in 7th floor wer excluded from the survey. Through the interview with staffs by a public health nurse and an inspection of the work place with sanitary inspectors, it was concluded to expand the survey to the staffs working in the 7th floor, and another newly infected persons were found. Staffs in a small company do not belong to “danger group”, but the importance of investigations by public health officials was suggested in the case of suspected outbreak.View full abstractDownload PDF (892K) -
Hidekazu MATSUSHIMA, Yutaka SUGITA, Tsutomu YANAGISAWA, Mikio UBUKATA, ...2003 Volume 78 Issue 5 Pages 401-406
Published: May 15, 2003
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSA 71-year-old male was admitted to our hospital with dyspnea on effort. He had been prescribed rifampicin, isoniazid sodium methanesulfonate (IHMS), and ethambutol for pulmonary tuberculosis, and ursodesoxycholic acid for alcoholic liver dysfunction. The chest HRCT revealed diffuse ground-glass attenuation with interlobular interstitial thickening. BALF showed lymphocytosis, and TBLB revealed organizing pneumonia. All medications were interrupted, and his respiratory failure and chest HRCT findings were improved. He started again medications excluding IHMS, his condition continued to improve further. DLST to causative IHMS was negative with peripheral blood lymphocytes, but was positive with lymphocytes from BALF. Therefore, we diagnosed this case as having IHMS induced interstitial pneumonia. In the past, 5 cases of isoniazid induced interstitial pneumonia were reported, but IHMS induced interstitial pneumonia has not been reported. Clinicians need to be aware of drug induced interstitial pneumonia by anti-tuberculosis drugs including IHMS in patients receiving anti-tuberculosis drugs.View full abstractDownload PDF (1806K) -
Shuichi YANO, Kanako KOBAYASHI, Kazuhiro KATO, Shinji SAITO2003 Volume 78 Issue 5 Pages 407-410
Published: May 15, 2003
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSAn 81-year-old man was admitted to our hospital because of pericardial effusion and sputum PCR positive for Mycobacterium (M.) tuberculosis. Since adenosine deaminase (ADA) value of the pericardial effusion was not high and the sputum smear and culture were negative, anti-tuberculous therapy was not started. Two months later he was admitted again because of high fever and cardiomegaly. Chest cornputed tomography showed deterioration and the sputum culture revealed M. tuberculosis. The ADA value of the pericardial effusion which was not high at the first admission, was elevated in the second admission, and the diagnosis was made as tuberculous pericarditis two months later. We had better start anti-tuberculous therapy at the first admission, spite of low value of ADA, as his pericardial effusion showed lymphocyte predominance.View full abstractDownload PDF (1151K)
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